Private Boat - Emergency O2

[Blackcrusader]

The question is about carrying oxygen on a boat in remote locations.

I think the OP has a commendable idea that carrying O2 on his boat for an emergency is a good idea. I often ask dive centers if they have an O2 bottle on board when doing boat dives. Even in places where a chamber is available the time taken to get to one can be an issue.

 

[tursiops]

I think the OP has a commendable idea that carrying O2 on his boat for an emergency is a good idea. I often ask dive centers if they have an O2 bottle on board when doing boat dives. Even in places where a chamber is available the time taken to get to one can be an issue.

O2 on the boat is one thing; O2 hanging at 20ft is another. I think we all agree on the former.

 

[FF / EMT]

O2 on the boat is one thing; O2 hanging at 20ft is another. I think we all agree on the former.

We can all agree on where it comes from too.







photosynthesis….

 

[broncobowsher]

Correct hose length to prevent using at an unsafe depth. Problem solved.

 

[Wibble]

Correct hose length to prevent using at an unsafe depth. Problem solved.

Aren’t the divers experienced enough to hold a stop? They should be given they’re diving at the back of beyond.

A length of rope would work if throwing it overboard.

 

[rjack321]

Correct hose length to prevent using at an unsafe depth. Problem solved.

Not exactly.

Telling a recreational diver to do IWR - means the boat can't move. Which delays access to higher levels of care, runs the risk of hypothermia, has risks of oxygen toxicity, potentially in water alone, has many issues with the twice daily tides in this region.

Choosing to run the boat at the highest practical speed, with the patient on surface O2, to a higher level of medical care is the standard of care here.

If this were my boat and dive plans I would:

1. Plan to dive conservative profiles in buddy pairs
2. Leave two people on the boat both to operate it and to aid any injured divers
3. Have enough surface o2 aboard to actually reach an ambulance
4. Have an AED aboard
5. Having a satellite phone, inreach, or similar to notify first responders that you're coming with a dive accident victim.

 

[RVBldr]

Never liked the small DAN bottles, so I keep a 40 with this adapter: DGX Gears Adapter: DIN to CGA-870 Pin Index POST.

 

[broncobowsher]

Aren’t the divers experienced enough to hold a stop? They should be given they’re diving at the back of beyond.

A length of rope would work if throwing it overboard.

I've seen a rope break and the tank drop. It was recovered a week later.

Not about holding a stop, just a tether so the wrong gas can't be used at the wrong depth.

 

[MaxBottomtime]

A New Look at In-Water Recompression (IWR)

What is your best option if you or a team-mate get bent at a remote diving location, that is more than two hours from a chamber? If you are prepared—that means having the right equipment and know-how—the new consensus among the hyperbaric docs is to treat with In-Water Recompression (IWR).

gue.com

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A New Look at In-Water Recompression (IWR)​

What is your best option if you or a team-mate get bent at a remote diving location, that is more than two hours from a chamber? If you are prepared—that means having the right equipment and know-how—the new consensus among the hyperbaric docs is to treat with In-Water Recompression (IWR).

Published
3 years ago
on
July 2, 2019
By
InDepth

• 
  
  
  

by Reilly Fogarty
Header Image: Photo courtesy of DAN.
Depending on who you ask, in-water recompression (IWR) is either a critical life-saving tool for experienced divers or a fast-track to becoming a case report. Casually dropping it in conversation is a great way to make hyperbaric medicine experts froth at the mouth, and it’s the stuff that insurance underwriters have nightmares about. Putting a diver back in the water after a serious injury is not something to be taken lightly. Managing the diver requires significant training and equipment, as well as the training to diagnose a diver before treatment and manage them and any possible complications afterwards.
Even in ideal conditions, recompression (in-water or in a chamber) is not guaranteed to eliminate or even ameliorate symptoms, and there’s a very real possibility that divers may exit the water in worse shape than when they entered due to oxygen toxicity, natural symptom progression, or further exposure to the elements. Despite all of this, the practice has been saving lives in some of the world’s least hospitable environments for decades, and recent research has shown that there may be even more reasons to consider IWR.

Divers Decompressing. Photo courtesy of DAN.
At the recent International Rebreather Meeting in Ponza, Italy, Simon Mitchell, Ph.D., presented a new take on IWR taken from In-Water Recompression, a paper he recently published with David Doolette, Ph.D. The pair propose that IWR may be the best option in a much broader array of situations than previously thought, and that it should be applied in situations where a diver is at risk of losing life or limb, a chamber is more than two hours away, and the team is appropriately trained and equipped for the protocols.

Illustration of the Australian In-Water Recompression Treatment from “In-Water Oxygen Recompression: A Potential Field Treatment Option for Technical Divers, aquaCORPS # 5 BENT, JAN93. Graph by Richard L. Pyle
First, a little background: IWR tables vary, but most modern protocols involve administering oxygen at 30 fsw/9 msw for one to three hours. Historically, these protocols have varied widely, from the use of oxygen down to 60 fsw/18 msw to “deep air” spikes down to 165 fsw/50 msw. The supporting evidence underlying these practices and the extent of testing also vary widely. Up until the last decade or so the practice was considered foolhardy at best and dangerous at worst by most experts, and was reserved as a tool of last resort for divers who got bent in areas where recompression in a chamber wouldn’t be possible for days. At the time, the leading researchers were working under the assumption that delay to recompression had little or no effect on post-treatment outcomes, and both the logistics of sourcing open-circuit gas supplies and managing oxygen toxicity risk made it difficult enough to organize that most experts avoided broaching the subject.
In the past decade many of these concerns have found technological workarounds or have seen a reversal in best-practices. Increasingly, injury data is showing that minimizing time to recompression is key to positive outcomes in cases of decompression sickness (DCS) of all types, and the difficulty of providing oxygen to divers has diminished dramatically with the proliferation of rebreather use. IWR today may just require an injured rebreather diver and their buddy to reenter the water and clip into a hangar with an extra cylinder of oxygen and some way to maintain a patent airway (via full face mask, mouthpiece, or gag strap). Our understanding of oxygen toxicity and the applicable risk factors has improved, as has our ability to diagnose and manage serious DCS, but the combination of factors seems to have come together without much notice until Mitchell and Doolette took on the project of standardizing and promoting a procedure.

Divers Decompressing. Photo courtesy of DAN.
Citing retrospective analyses of military and experimental dives that showed complete resolution of DCS symptoms during the first treatment (and often within minutes of initial recompression) in 90 percent of cases, the two advocate strongly for a delay to recompression of less than two hours. Realistically, a promptly diagnosed condition and initiated IWR protocol could have a diver back under pressure in half that time or less, but there is little research into whether recompression in that short period notably improves outcomes. The primary protocols outlined in the paper involve the use of oxygen for one to three hours at 30 fsw/9 msw, a notable departure from what most non-commercial and non-military divers are used to in terms of oxygen exposure, but they are widely accepted and have significant research backing.
In addition to the hazards of CNS oxygen toxicity, convulsions in the water, and symptom progression in a difficult environment, Doolette and Mitchell highlight both the inability to further evaluate patients in the water and the lack of applicable medical interventions. IWR is not a cure-all, nor is it something to be undertaken on a whim, but it has been a viable option for decades for those appropriately trained and equipped, and it’s refreshing to see those at the forefront of the industry promote the evidence-based practices we need in order to save divers in extreme situations.

 

[NW Dive Dawg]

Thanks for the great comments.

Well this thread has been an enlightening and a fun journey. As the OP, I just wanted to thank all of you folks who responded. Even some of the folks who think it's their role in life to tell everyone to do things their way only...... they also provided some valuable food for thought!

In the end, I've made my decisions and already ordered some of the items I want on my boat...

1) AL80, brushed finish with convertible valve, pre-O2 cleaned for 100% O2.
2) DGX Gears Adapter: DIN to CGA-870 Pin Index POST.
3) Lightning X O2 Mini Oxygen Regulator CGA-870 Gauge Flow Rate 0-15 lpm w/Wrench...
4) 2 each - Ausilium Oxygen Therapy Mask - With Tubes
5) 2 Each - OXYGEN 100% tank stickers from DRIS
6) Sea Elite Rubber LP Regulator Hose 30 Ft 3/8 in bright Yellow. Actual 2nd stage depth will be 20ft.
7) RescuEAN - (TBone) I very much enjoy reading all of your threads and very much appreciate your balanced approach to providing solid advise.

I already have everything else I need to complete my plan to have BOTH in water and on deck options ....... as long as we're all agreed that my Mares brand new in the box Abyss 22 is good to go for 100% O2.

So that's it.... Thanks again. PS..... Stay tuned for another thread dedicated to emergency O2 delivery training...

Cheers...